CAJ | 학술논문

原发性胆汁性肝硬化（PBC）是一种自身免疫性疾病，熊去氧胆酸（UDCA）是唯一经随机对照临床试验证实治疗PBC安全有效的一线治疗药物，对于UDCA反应不佳者亟需其他有效的药物治疗。回顾了UDCA的疗效，重点叙述了对UDCA反应不佳者的备选治疗和辅助治疗的分类和最新研究进展，评估了药物的疗效和治疗前景，但布地奈德、依那西普等免疫抑制剂和其他类药物的疗效有待更多长期临床试验来验证。一些新兴的PBC分子疗法正处于积极的临床研究中。目前，对UDCA反应欠佳者的药物治疗方法尚不确定，尽管研究表明部分药物可以改善肝功能和肝脏生化指标，尚无确切的证据证明可改善长期预后。
원발성담즙성간경화（PBC）시일충자신면역성질병，웅거양담산（UDCA）시유일경수궤대조림상시험증실치료PBC안전유효적일선치료약물，대우UDCA반응불가자극수기타유효적약물치료。회고료UDCA적료효，중점서술료대UDCA반응불가자적비선치료화보조치료적분류화최신연구진전，평고료약물적료효화치료전경，단포지내덕、의나서보등면역억제제화기타류약물적료효유대경다장기림상시험래험증。일사신흥적PBC분자요법정처우적겁적림상연구중。목전，대UDCA반응흠가자적약물치료방법상불학정，진관연구표명부분약물가이개선간공능화간장생화지표，상무학절적증거증명가개선장기예후。
Primary biliary cirrhosis (PBC)is an autoimmune disease.Ursodeoxycholic acid (UDCA)is the only safe and effective drug for the treatment of PBC,as proved by randomized controlled clinical trials,so it is advocated as first-line therapy.Alternative therapies are urgently needed for patients with poor response to UDCA.In addition to the efficacy of UDCA,the classification of alternative and adjuvant therapies for UDCA nonresponders and the latest research progress in these therapies are reviewed;the efficacy of existing drugs and treat-ment prospects are evaluated,but more long-term clinical studies are needed to confirm the efficacy of immunosuppressants such as budes-onide and etanercept and other drugs.A number of novel molecular therapies for PBC are also undergoing clinical trials.There is currently no consensus on the medical treatment for patients with poor response to UDCA.Although studies have shown that some drugs can improve liver function and liver biochemistries,there is no definitive evidence that they improve long-term outcome.